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SPC Clinical 2 Final

High blood pressure or head trauma would be a ______ of placing a pt in a head down position. Contraindication
What rules should always be followed when giving CPT? Never just after meals, watch pt's face, furthest bed railing up
Prone position w/ foot of bed elevated drains what segments/lobes? Posterior basal & lower
Percussive Therapy is best described as: Cupped hands trapping air as hand strikes pt's chest
Splinting is: Support of incision during coughing to ease pain
Postural draining typically indicated with: Pneumonia
Hazards of postural drainage: Increased intracranial pressure, transient hypoxemia, & acute airway obstruction
How many segments in the R & L lungs? 10 & 8
Supine position, pillow under knees, w/ foot of bed slightly elevated drains what segment/lobe? Anterior basal, lower
Pt laying 1/4 turn from prone w/ a pillow between legs, draining which segment/lobe? Lateral, lower
Prone w/ a pillow under pt's stomach & foot of bed elevated, draining which segment/lobe? Posterior basal, lower
CPT does not treat: Plural abscess
Race Epi (what,dose) Bronchodilator(rescue drug),0.25-0.5ml
Mucomyst (what,dose) Mucolytic, reduce mucus volume & viscocity, 10% recomm. but 20% also avail., give w/ bronchodilator, stinks, don't give to nauseated pts, short-term use
Atrovent(ipratropium bromide) (what, dose) Anticholinergic, prevent constriction in larger intermediate airways, SVN: 0.5mg w/ 2-3ml saline, MDI: 18ug/puff - 2 puffs QID
Combivent(ipratropium bromide & albuterol sulfate) (what, dose) Anticholinergic(larger airways) & sympathomimetic(smaller/lower airways), MDI: 18ug ipratropium 90ug albuterol, not for pts w/ soy or peanut allergies
Advair(fluticasone & salmeterol) (what, dose) Corticosteroid & sympathomimetic, DPI Discus or MDI: 100/250/500ug fluticasone 50ug salmeterol/puff (1 BID)
Xopenex(levalbuterol) (what, dose) Sympathomimetic, smaller/lower airways SVN: 0.63/1.25mg w/ 3ml saline, MDI: 45ug/puff
Pulmozyme(dornase alpha) (what, dose) Proteolytic, thin infectious mucus, 2.5mg ampoule
Spiriva(tiotropium bromide) (what, dose) Anticholinergic, larger airways, DPI: 18ug/capsule (QD)
Asepsis Free from infection
Aseptic technique Methods used to prevent contamination
Colonization Presence & growth of microbes in a host
Disinfection Complete destruction of vegetative microorganisms - not spores
Gram-negative Bacteria that DO NOT retain their basic stain after alcohol wash
Gram-positive Bacteria that DO retain their basic stain after alcohol wash
Nosocomial infection Hospital acquired infection
Pathogenic Disease producing
Pseudomonis aeruginosa Gram negative bacilli known for rapid appearance in water reservoirs (ex: nebs)
Sterilization Process that results in the absence of living microorganisms - includes spores
Sterile To be absent of living microorganisms - includes spores
Ziehl-Neelsen stain(AFB) Acid-fast stain used to identify acid-fast organisms
Dry Heat method Sterilize, 160-180C, 2hrs, only glass & metals
Ethylene Oxide (ETO) method Sterilize, 50-56C, 30-60% humidity, 3-4hrs, items must be dry, kills by alkylation, mix w/ 10-15% CO2 otherwise explosive, don't ETO PVC, aerate plastics up to 12hrs.
Glutaraldehyde method Alk form 10mins disinfection - 10hrs for sterilization, Acid form 20mins disinfection - if heated to 60C will sterilize in 1 hr, denatures proteins, very irritating
Quaternary method Disinfectant, bactericidal activity is limited
Gamma Radiation method Sterilize, very effective, expensive, requires extensive facility & equipment
Ultraviolet method Limited use, kills most - not all - bacteria
Betadine(iodophor) Disinfectant, less irritating than iodine though less bactericidal
Isopropyl alcohol Disinfectant
Output Sampling surveillance Test in-use or cleaned equip, colony counts, quantitative, amounts & types compared to ambient air, excessive = positive
Rinse Sampling surveillance Monitor effectiveness of process method, sloshed in sterile broth, broth incubated, quantitative, sensitive to growth
Swab Sampling surveillance Monitor in-use equip, sterile swab on single location, swab inoculate auger plate or broth for incubation, qualitative *most common method
Glutaraldehyde requires what to be activated? NaHCO3
Steam autoclaving used what level of pressure? 15psi
Autoclave & glutaraldehyde are effective against? Tuberculosis organisms
Autoclave & ETO are effective in killing? Spores
What older bronchodilator has more cardiovascular effects? Metaprel (metaproterenol or alupent)
Hypoventilation can be caused by? High FiO2 delivered to CO2 retainer
What happens to FiO2 if resistance builds up in a venturi device? Increases
IPPB breathing issues Breathing pattern unnatural, pt should relax & allow vent to fill lungs, exhalation passive
IPPB sensitivity Set auto-trigger, then slowly decrease until pt able to trigger easily
IPPB hazards/complications Hypocapnea, hyperventilation, decreased CO, increased ICP, pneumothorax
After reviewing the physician's order & the CXR, what next would best help determine where CPT should be concentrated? Ausculate & percuss
CPT/PD contraindications Cardiovascular instability, undrained empyema, lung abscess, hemoptysis
High Flow devices Air Entrainment Mask (venti mask)
Low Flow devices Nasal cannula, simple O2 mask, partial re-breathing mask, non-rebreather
Suction pressure should not exceed 120 when end of suction tube occluded
Autoclave Sterilization, 15psi @ 121C for 15 min, very effective, limited use on certain materials due to high heat
Created by: vgflgirl
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